Summary

Psychologist Ray Blanchard tested an idea, drawn from Kurt Freund's work, that male-to-female transsexuals come in two basic types. Using routine questionnaires at a Toronto gender clinic, he grouped 163 patients by attraction to men and women. He asked whether they had ever been sexually aroused while cross-dressing. Two-thirds or more of those attracted to women, to both sexes or to neither said yes, compared with 15% of those attracted to men. Blanchard concluded that the groups not attracted only to men form one family, separate from those attracted to men. The paper became the basis of his later 'autogynephilia' theory and of a label in the main US psychiatric manual (DSM-5). Its evidence is a single self-reported question from one 1980s clinic, with small groups and no comparison group, and critics question whether the types hold up elsewhere.

Key findings

• 163 pasien transseksual laki-laki ke perempuan di sebuah klinik jiwa Toronto mengisi kuesioner tentang ketertarikan seksual. Usia rata-rata mereka sekitar 30 tahun.
• Metode statistik yang memilah orang berdasarkan skor yang mirip, ditetapkan sebelumnya untuk menemukan empat kelompok, menghasilkan 100 pasien tertarik pada laki-laki, 35 tertarik pada kedua jenis kelamin, 16 tertarik pada perempuan, dan 12 tidak tertarik pada keduanya.
• Rangsangan seksual saat memakai pakaian lawan jenis dilaporkan oleh 14 dari 16 yang tertarik pada perempuan (88%), 9 dari 12 yang tidak tertarik pada keduanya (75%), dan 23 dari 35 yang tertarik pada kedua jenis kelamin (66%), dibandingkan 15 dari 100 yang tertarik pada laki-laki (15%).
• Kelompok yang tertarik pada laki-laki berbeda jelas dari masing-masing kelompok lain, sementara ketiga kelompok lainnya tidak berbeda jelas satu sama lain.
• Blanchard menyimpulkan bahwa mereka yang tertarik pada kedua jenis kelamin atau pada keduanya tidak adalah varian dari mereka yang tertarik pada perempuan, sehingga ada dua tipe dasar: tertarik pada laki-laki, dan tidak (kemudian disebut 'autoginefilik').
• Studi ini adalah titik awal bagi tipe-tipe Blanchard dan gagasan autoginefilia-nya tahun 1989, yang kemudian dipakai oleh manual psikiatri AS DSM-5 untuk label yang dilekatkan pada diagnosis gangguan berpakaian lawan jenis.

Abstract

This study tested a prediction derived from the hypothesis that asexual and bisexual transsexualism are actually subtypes of heterosexual transsexualism. Two questionnaire scales measuring erotic attraction to males and females were administered to 163 male-to-female transsexuals. A cluster analysis of their scores divided the subjects into four groups: heterosexual, homosexual, bisexual, and asexual. Fisher Exact tests were used to compare the frequency with which subjects in the four clusters reported a history of erotic arousal in association with cross-dressing. As predicted, there were no differences among the asexual, bisexual, and heterosexual transsexuals, and all three groups included a much higher proportion of fetishistic cases than the homosexual group (p less than or equal to .0001, two-tailed). These findings support the view that male transsexuals may be divided into two basic types: heterosexual and homosexual.

Conclusion

The prediction that asexual and bisexual transsexuals would report a history of cross-gender fetishism about as often as heterosexual transsexuals, and much more often than homosexual transsexuals, survived what Blanchard called an objective, 'hands-off' test that could have shown it false. He argued that anyone dissatisfied with his hypothesis must offer an alternative that explains the high rates of cross-gender fetishism in the asexual and bisexual groups and makes a new, testable prediction. He concluded that male transsexuals may be divided into two basic types, heterosexual and homosexual, with the asexual and bisexual forms being variants of the heterosexual type.